@include('front.components.merchant.page-title')
@include('front.components.merchant.application-progressbar') @include('front.components.merchant.copy-btn') {!! html()->form('POST', route('merchant.business-overview.submit'))->attributes(['id' => 'business-overview-form', 'data-parsley-validate' => true])->open() !!} {!! html()->hidden('application_number', $data->application_number ?? null) !!} {!! html()->hidden('merchant_location_id', $location_id ?? null) !!} {!! html()->hidden('id', $business->id ?? 0) !!} @if ($isGuestUser) {!! html()->hidden('token', $token ?? null) !!} @endif
{{-- Business Overview --}}
{!! html()->label('Country', 'location_country_id') !!} * {!! html()->select('location_country_id', ['' => 'Select'] + $countries, $business->location_country_id ?? 231)->class('form-control select2')->required() !!}
{!! html()->label('Entity Type​', 'entity_type_id') !!} * {!! html()->select('entity_type_id', ['' => 'Select'] + $entity_types, $business->entity_type_id ?? '')->class('form-control select2')->id('entity-type-select')->required() !!}
{!! html()->checkbox('is_public_company', $business->is_public_company ?? false, 1)->class('custom-control-input')->id('formrow-customCheck') !!} {!! html()->label('This is a Public Company', 'formrow-customCheck')->class('custom-control-label') !!}
{!! html()->label('Do you have Employees?', 'has_employee') !!} * {!! html()->select('has_employee', ['' => 'Select', '1' => 'Yes', '0' => 'No'], $business->has_employee ?? '')->class('form-control select2')->required() !!}
{!! html()->label('Legal Business Name', 'business_name') !!} *
{!! html()->text('business_name', $business->business_name ?? '')->class('form-control disable-autocomplete')->required() !!}
{!! html()->label('DBA - Statement Descriptor', 'dba_statement_descriptor') !!}
{!! html()->text('dba_statement_descriptor', $business->dba_statement_descriptor ?? '')->class('form-control')->id('basicpill-email-input') !!}
{!! html()->checkbox('is_same_as_business_name', $business->is_same_as_business_name ?? false, 1)->class('custom-control-input')->id('formrow-customCheck2') !!} {!! html()->label('Same as Legal Business Name', 'formrow-customCheck2')->class('custom-control-label') !!}
{!! html()->label('Industry​', 'master_industry_id') !!} * {!! html()->select('master_industry_id', ['' => 'Select'] + $industries, $business->master_industry_id ?? '')->class('form-control select2')->required() !!}
{!! html()->label('TIN Type', 'tin_type_id') !!} * {!! html()->select('tin_type_id', ['' => 'Select'] + $tin_types, $business->tin_type_id ?? '')->class('form-control select2')->required() !!}
{!! html()->label('TIN', 'tin') !!} *
{!! html()->text('tin', $business->tin ?? '')->class('form-control input-mask')->attribute('data-inputmask', "'mask': '99-9999999'")->attribute('data-inputmask-clearincomplete', 'true')->attribute('autocomplete', 'off')->required()->attribute('data-parsley-pattern', '^\d{2}-\d{7}$')->attribute('data-parsley-pattern-message', 'Please enter a complete 9-digit TIN in XX-XXXXXXX format')->attribute('data-parsley-required-message', 'TIN is required with all 9 digits') !!}
{!! html()->label('Business Phone', 'business_phone') !!} *
{!! html()->text('')->class('form-control right-border-radius0 no-right-border front-phone-code')->placeholder('1 -')->disabled() !!} {!! html()->text('business_phone', $business->business_phone ?? '')->class('form-control input-mask disable-autocomplete left-border-radius0 front-phone-number')->required()->attribute('autocomplete', 'off')->attribute('data-inputmask', "'mask': '(999) 999-9999'")->attribute('data-parsley-required-message', 'Please enter your phone number')->attribute('data-parsley-pattern', '^\(\d{3}\) \d{3}-\d{4}$')->attribute('data-parsley-pattern-message', 'Please enter a valid phone number (e.g. (123) 456-7890)') !!}
{!! html()->label('Business Email', 'business_email') !!} * {!! html()->email('business_email', $business->business_email ?? '')->class('form-control disable-autocomplete')->required()->attribute('autocomplete', 'off')->attribute('pattern', '[A-Za-z0-9._%+-]+@[A-Za-z0-9.-]+\.[A-Za-z]{2,}$')->attribute('title', 'Please enter a valid email address')->attribute('data-parsley-required-message', 'Please enter your email') !!}
{!! html()->label('Business Website', 'business_website')->class('mb-0') !!}
{!! html()->checkbox('has_business_website', $business->has_business_website ?? false, 1)->class('custom-control-input')->id('formrow-customCheck3') !!} {!! html()->label("Don't have Business Website", 'formrow-customCheck3')->class('custom-control-label') !!}
https://
{!! html()->text('business_website', $business->business_website ?? '')->class('form-control') !!}
{!! html()->label('Customer Service Phone', 'customer_service_phone') !!}*
{!! html()->text('')->class('form-control right-border-radius0 no-right-border front-phone-code')->placeholder('1 -')->disabled() !!} {!! html()->text('customer_service_phone', $business->customer_service_phone ?? '')->class('form-control input-mask disable-autocomplete left-border-radius0 front-phone-number')->attribute('autocomplete', 'off')->attribute('data-inputmask', "'mask': '(999) 999-9999'")->attribute('data-parsley-pattern', '^\(\d{3}\) \d{3}-\d{4}$')->attribute('data-parsley-pattern-message', 'Please enter a valid phone number (e.g. (123) 456-7890)')->required() !!}
@php $selectedKey = array_search( 'Salon & Spa', $business_types, ); // Find key for "Salon & Spa" @endphp
{!! html()->label('Type of Business', 'master_business_type_id') !!} *
How does the business primarily take payments?*
business_taking_payment_type ?? '') == 1 ? 'checked' : '' }} required>
business_taking_payment_type ?? '') == 2 ? 'checked' : '' }} required>
business_taking_payment_type ?? '') == 3 ? 'checked' : '' }} required>
{{-- Business Details --}}
{!! html()->label('Description for your bank statement', 'description_bank_statement') !!} {!! html()->text('description_bank_statement', $business->description_bank_statement ?? '')->class('form-control form')->attribute('placeholder', 'Secondary Descriptor') !!}
{!! html()->label( 'What does your business process payments for, and how are goods sold?', 'business_process_for', ) !!}* {!! html()->text('business_process_for', $business->business_process_for ?? '')->class('form-control form')->attribute('placeholder', 'Describe the goods and services you commonly provide here.')->attribute('maxlength', 15)->attribute('pattern', '^.{0,15}$')->attribute('title', 'Please enter between 0 and 15 characters')->required() !!}
{!! html()->label('Date Business Established', 'business_established_date') !!}* {!! html()->text('business_established_date', $business->business_established_date ?? '')->class('form-control datepicker form')->id('business_established_date')->required()->attribute('placeholder', 'MM-DD-YYYY') !!}
{!! html()->label('Annual Processing Volume (US dollars USD)', 'annual_processing_volume') !!}*
$
{!! html()->text('annual_processing_volume', $business->annual_processing_volume ?? '0.00')->class('form-control currency-format no-left-border decimal-places')->required()->attribute( 'data-inputmask', "'alias': 'currency', 'groupSeparator': ',', 'autoGroup': true, 'digits': 2, 'digitsOptional': false, 'prefix': '', 'placeholder': '0.00', 'rightAlign': false", ) !!}
{!! html()->label('Average Transaction (Card/ACH) Amount $US (US dollars)', 'avg_transaction_volume') !!}
$
{!! html()->text('avg_transaction_volume', $business->avg_transaction_volume ?? '0.00')->class('form-control currency-format no-left-border small-width decimal-places')->attribute( 'data-inputmask', "'alias': 'currency', 'groupSeparator': ',', 'autoGroup': true, 'digits': 2, 'digitsOptional': false, 'prefix': '', 'placeholder': '0.0', 'rightAlign': false", ) !!}
{{-- Business Address --}}
{!! html()->label('Address', 'business_addressline_one') !!}* {!! html()->text('business_addressline_one', $business->business_addressline_one ?? ($data->full_address ?? ''))->class('form-control location-address')->id('business_addressline_one')->required() !!} {!! \App\Helpers\Helper::addressNote() !!}
{!! html()->label('Address 2 (Optional)', 'business_addressline_two') !!} {!! html()->text('business_addressline_two', $business->business_addressline_two ?? '')->class('form-control') !!}
{{--
{!! html()->label('City', 'business_city_id') !!}* {!! html()->select('business_city_id', ['' => 'Select'] + $cities, $business->business_city_id ?? '')->class('form-control select2')->required() !!}
--}}
{!! html()->label('City', 'city_name') !!}* {!! html()->text('city_name', $business->city_name ?? ($data->city_name ?? ''))->class('form-control')->required() !!}
{!! html()->label('State', 'business_state_id') !!}* {!! html()->select('business_state_id', ['' => 'Select'] + $states, $data->location_state_id ?? '')->class('form-control select2')->required() !!}
{!! html()->label('Zip', 'zip') !!}* {!! html()->text('zip', $business->zip ?? ($data->zip ?? ''))->class('form-control numeric')->attribute('minlength', 5)->attribute('maxlength', 5)->attribute('pattern', '^\d{5}$')->attribute('title', 'Please enter a 5 digit zip code')->required() !!}
{{-- End Accordion --}}
{!! html()->form()->close() !!}